propranolol info

Propranolol - Patient Information

What is Propranolol?

Propranolol is classified under a group of medicines called beta-blockers. A beta-blocker medicine can help control the body’s fight-or-flight response and reduce its impact on the heart. Beta-blockers can slow down the heart rate and also make it easier for the heart to pump blood. People who take beta-blockers, often do so to treat conditions like:

A beta-blocker is a prescription medicine that doctors can prescribe for off-label use. These are the common reasons for prescribing beta-blockers off-label:

You can learn more about how beta-blockers work to manage performance anxiety and if it works for you or not.

How Beta-Blockers Work

Beta-blockers are also known as beta-adrenergic blocking agents. These prevent a stress-related hormone called adrenaline from making contact with the heart’s beta receptors. By blocking the actions of adrenaline, they keep the heart from pumping harder and faster. They not only relax the heart, but some beta-blockers can also relax the blood vessels and as a result, reduce blood pressure.

There are several beta-blockers available, but these are the most common ones:

acebutolol (brand name Sectral®)
bisoprolol (brand name Zebeta®)
carvedilol (brand name Coreg®)
atenolol (brand name Tenormin®)
metoprolol (brand name Lopressor®)

The type of beta-blocker commonly prescribed at Thrones Health platform is known as Propranolol. This may be sometimes sold under brand name Inderal®

Beta-blockers used to treat anxiety are generally prescribed off-label. In Propranolol’s case, the beta-blocker is commonly prescribed off-label to ease and treat performance anxiety.


When a drug is prescribed off-label, it means that the drug functions as medicine or treatment for a specific condition that has not been explicitly approved by FDA for that particular drug. In some cases, the FDA-approved drugs for specific conditions are found to be safe and effective treatment alternatives for conditions not noted by the FDA for that specific drug. It’s important to note that FDA doesn’t regulate medical practice, and for this reason, licensed physicians may prescribe a drug as off-label whenever they determine that the drug is appropriate to be used for a particular treatment in line with the patient’s condition.

How Beta-Blockers Help With Performance Anxiety

Beta-blockers may have its limits in terms of addressing the psychological causes and triggers of performance anxiety, however, they can help manage some of its physical manifestations and symptoms, including:
The body naturally reacts to stress. Beta-blockers can help minimize the body’s natural and physical reactions to stress, making you feel less anxious even during highly stressful moments.
Beta-blockers are ideal for managing short-term anxiety towards specific events, but have little to no effect with long-term anxiety. A beta-blocker can be good to use before an event that makes you feel anxious such as giving a public speech. It can help make you feel less anxious.
People can still respond differently to medications, and beta-blockers are no exception. This is especially true when treating mental health conditions like anxiety. Treatment may work effectively for one person, and not at all work for someone else. Additional treatment alternatives may be necessary when treating anxiety with beta-blockers. You may effectively address physical symptoms of anxiety, but the psychological causes necessitate a different approach and strategy for healing.

Taking Beta-Blockers for Performance Anxiety

Propranolol is a prescription medicine that should be taken at the exact dosage prescribed and comes in a pill. The amount to be taken depends on your medical history and type of beta-blocker prescribed by the doctor. Golden rule: just never take more than what is prescribed. In taking beta-blockers for performance anxiety, you may likely notice results immediately. If not, it takes an hour or two to reach the maximum effect of the drug. Within this time, you will observe that your heart rate will decrease, as a result you will feel more relaxed.
Physicians serving through the Thrones Health platform will typically prescribe one 20mg Propranolol tablet to qualified patients. This is considered to be a low dose, and must be taken at least 30-60 minutes before the anxiety-inducing, stressful event. If prescribed to you, you will typically also be provided a total of 4, 6, 8, 10, or 12 pills every month, depending on your doctor’s medical evaluation. Just don’t take more than 2 tablets within a 24-hour period.

Possible Side Effects

Beta-blockers come with side effects which can be felt by most who are taking them for the first time. If you take beta-blockers daily, these side effects may become even more common. You must therefore take beta-blocker on an “as needed” basis to address performance anxiety. Taking it daily for performance anxiety is highly discouraged.

Side Effects are:

Side effects can be more serious. Consult your doctor immediately / go to the emergency room if you experience any of these:

If you begin to notice mild side effects, make sure to not stop taking the beta-blocker without consulting your doctor first. These could come with serious withdrawal symptoms.
There are people whose side effects to the beta-blocker come in the form of anxiety symptoms. If you suddenly feel that beta-blockers are increasing your anxiety level, consult with your doctor for the best way to go about it.

Who Should Not Be Taking Beta-Blockers?

Beta-blockers are safe in general, but some people should not be taking them. If you have any of the following conditions, be sure to inform your doctor before taking any beta-blocker.
In case you have any of these conditions or symptoms mentioned above, beta-blockers can still be safe for you, but take them with precaution and with the guidance of your doctor. Beta-blockers may also cause an interaction with other medications you’re currently taking. For this, beta-blockers may be sensitive for people with existing heart conditions and those already on antidepressants. Always keep your doctor updated and work with them to safely take beta-blockers with your current prescription medications, OTC medicines, vitamins, and supplements.
The general rule is, if you’re not sure about taking propranolol with your other medicines, always consult your doctor first.


It’s not unusual for some people to get allergic reactions to this medicine and other medicines. If you have other types of allergies such as to foods, medicines, and other substances (e.g. dyes), work with your doctor closely to monitor allergic reactions. For non-prescription medicines, don’t forget to read the label carefully.

All Trimesters
There are no animal studies that have been conducted to show any adverse effect on pregnant women.

Breast Feeding

There are currently no adequate studies on women finding infant risk when using this medicine while breastfeeding. Always weigh potential risks and potential benefits of this medicine before using it while breastfeeding.

Can I Overdose and What Will Happen If Ever?

If this happens, seek medical attention immediately. Or call the Poison Helpline at 1-800-222-1222. Learn more about Propranolol by accessing the PRESCRIBERS DIGITAL REFERENCE (PDR).

The bottom line

Beta-blockers can effectively help manage symptoms of people with performance anxiety. Propranolol is proven to be a viable treatment alternative for short-term anxiety, especially event-related stress. However, beta-blockers are not recommended for managing long-term anxiety.
If performance anxiety bothers you and you may want to try out beta-blockers to see if it eases your condition, we recommend booking an online consultation through the Thrones Health platform. Speak with our doctor on the safest and most effective treatment plan to help manage your symptoms.